| NPI | 1326404377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN TEMPLETON Owner/ Manager 631-626-1006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NY 250947) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016843) |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2016-01-06 |